Monday, November 28, 2011

Huh (All Payer Claims Database Edition)

The MA commission reviewing provider pricing regulation came out with recommendations a few weeks ago.  The headline is that this is another step towards pricing regulation, but something else caught my eye.  One of their recommendations was to increase price transparency, and included this (emphasis mine),
Access to the All-Payer Claims Database. DHCFP is currently in the process of developing an All-Payer Claims Database (APCD), pursuant to M.G.L. c. 118G §6.  The Special Commission recommends that the state make the APCD accessible to consumers, purchasers, providers, insurers, and researchers both for standardized queries and in support of research to analyze price variation consistent with the provisions of the Data Release regulations, 114.5 CMR 22.00 et seq. Such disclosure should carefully guard protected health information (PHI), consistent with the Health Insurance Portability and Accountability Act (HIPAA). In addition, the Special Commission recommends including third-party administrators that process claims for self-insuring employers among the entities required to submit claims data to the APCD, consistent with the filing requirements for insurers serving fully-insured employers and individuals, to the extent it is legally feasible to do so.
Back in February I emailed the Office for Oregon Health Policy and Research to see if citizens would have any access to Oregon's all payer data.  The answer was no, due to privacy restrictions.  Maybe I'll forward them a copy of the MA report...

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